MASLD fibrosis stage predicts 2.5-fold increased cardiovascular risk; Semaglutide and Resmetirom show dual benefits.

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 38% of adults globally and is increasingly recognized as a systemic cardiometabolic disorder. Cardiovascular disease (CVD) is the leading cause of death across all MASLD stages, yet fibrosis-based risk stratification is often absent from standard CVD risk models. There's a critical need to better integrate liver health markers into CVD risk assessment and develop therapies that address both hepatic and cardiovascular pathologies.

This comprehensive review synthesizes recent advances in the epidemiology, pathophysiology, biomarkers, and treatment of Metabolic dysfunction-associated steatotic liver disease (MASLD), specifically focusing on its profound implications for cardiovascular risk assessment and management. Researchers systematically evaluated current literature to identify key prognostic factors, including noninvasive tools like Fibrosis-4 (FIB-4) and liver stiffness measurement, and assessed the dual hepatic and cardiometabolic benefits of emerging pharmacotherapies such as semaglutide and resmetirom.

The review highlights that fibrosis stage is the strongest independent predictor of cardiovascular outcomes in MASLD. This factor confers up to a 2.5-fold increase in cardiovascular events, even beyond traditional risk factors. Noninvasive tools, including Fibrosis-4 (FIB-4) and liver stiffness measurement, also demonstrate significant predictive value for cardiovascular mortality in this population. MASLD affects 38% of adults globally, underscoring its widespread impact on public health.

Fibrosis stage is the strongest independent predictor of cardiovascular outcomes in MASLD, conferring up to a 2.5-fold increase in events beyond traditional risk factors. Emerging pharmacotherapies like semaglutide and resmetirom show promising dual benefits, addressing both hepatic pathology and cardiometabolic risk factors. Despite its clear prognostic value, fibrosis-based risk stratification remains largely absent from standard cardiovascular risk models.